Background: Chronic kidney disease (CKD) has been shown to be associated with reduced survival following Transcatheter Valve Implantation (TAVI). The aim of the present study was to assess the independent effect of acute kidney injury (AKI) following TAVI among patients with and without CKD.
Methods: Cox proportional hazards regression modeling was used to evaluate the independent association of CKD (defined according to the National Kidney foundation guidelines) and AKI (defined according to the Valve Academic Research Consortium) and 2-year survival among 224 patients who underwent TAVI in a tertiary medical center.
Results: Mean age of study patients was 81±7 years, 56% male were followed for up to 24 months (median=506 days [IQR 195-805]). Severe renal failure with glomerular filtration rate (GFR)<30 mg/min was found in 21 (9%) patients and AKI has occurred in 18 patients (8%). In a multivariate analysis both AKI (HR=2.9, p=0.02) and GFR<30mg/min (HR=3.1, p=0.01) were independent predictors of 2 year mortality. At 2-years of follow-up mortality rates were significantly higher among patients who developed AKI (34%) as compared with those who did not (13%; Figure). The association of AKI and increased mortality was observed among patients with and without CKD.
Conclusions: Acute kidney injury following TAVI is independently associated with increased long-term 
mortality risk regardless of baseline renal function.
